| NPI | 1104198670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MYERS Staff Nurse Ii 415-750-5676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2012-01-31 |