| NPI | 1124538681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY LISA KELLY Authorized Official 530-894-5933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |