| NPI | 1184080681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL SMITH Owner 916-955-3149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA A93664) |
| Additional Taxonomies | 261QM0801X (Licence: CA A93664) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |