| NPI | 1093345589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY HICKMAN Executive Director 510-467-4250 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2024-02-14 |