| NPI | 1124730643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOSHIA WEBSTER Supervisor 415-822-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2022-12-15 |