| NPI | 1346764081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYANA LANICE JAMILL CARTER Owner 510-253-5907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171381956) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-07-21 |