| NPI | 1205367141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DOLLISON Executive Director 415-505-6427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA 487005267) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-27 |