| NPI | 1306268867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORVILLE ROACHE Executive Director 650-364-7988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 4125) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2014-01-16 |