| NPI | 1407052087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA GUMP Program Director 916-438-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2007-09-06 |