| NPI | 1265995112 |
|---|---|
| Doing Business As | MENTAL HEALTH -DEJEAN MIDDLE |
| Entity Type | Organization |
| Authorized Contact | DONALD BRUCE BLASKY Chief Program Officer 415-755-2311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2021-08-02 |