| NPI | 1396188231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FITZROY D. WINTERS Owner 510-703-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20131207488) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |