| NPI | 1407913064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY KELSO Supervisor 707-784-2140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-07-18 |