| NPI | 1336554062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HENDERSON Administrator 510-302-8951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2021-04-05 |