| NPI | 1083940969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN LEE Gove RN Ment Grants Manager 415-561-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |