| NPI | 1215178199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY LICKING Office Manager 408-799-7372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430049AN) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |