| NPI | 1235915638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BOZARTH CEO 510-268-8120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2023-09-27 |