| NPI | 1366577207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA C WASKO Executive Director 408-236-6657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430001AN) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430001EN) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430001DN) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430001GN) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430001FN) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |