| NPI | 1063695617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVA R SPARKS Licensee Owner 415-922-1885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |