| NPI | 1114616570 |
|---|---|
| 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 | 2023-05-02 |
| Last Update Date | 2023-05-02 |