| NPI | 1114074739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA VERNELL FAIRLEY Program Director 415-864-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |