| NPI | 1174058598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS BROUGHTON EGGER Clinician/Co Owner 209-342-7309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA LCSW71348) |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2018-09-06 |