| NPI | 1295109817 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | MIZELLA NONE HAYWOOD Director Of Credentialing 805-445-7800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA mfc29100) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |