| NPI | 1366818031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA J CHANG Mft Intern 209-403-3748 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2016-12-30 |