| NPI | 1083069447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD BRUCE BLASKY Ed Behavioral Health 415-302-3685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2026-02-03 |