NPI | 1083392302 |
---|---|
Doing Business As | DISRUPTIVE THERAPY COLLECTIVE |
Entity Type | Organization |
Authorized Contact | ALICE BUI CEO 408-365-4238 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-07-06 |
Last Update Date | 2023-07-06 |