| NPI | 1396415980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LUCKING CEO 408-409-4167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-17 |