| NPI | 1336686369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE DEE PETTY-HANNUM Corporation Owner 707-495-5350 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA MFC43967) |
| Enumeration Date | 2017-01-29 |
| Last Update Date | 2017-01-29 |