| NPI | 1073137295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE PHUONG ERTLEY President 415-890-3791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |