| NPI | 1124651682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES SHELDON ANDERSON Executive Director 408-916-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2023-03-29 |