| NPI | 1164575874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DELANE Manager Of Credentialing 415-476-4029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 20713) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |