| NPI | 1417220914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA PARKER Developmental Supervisor 408-802-1015 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-06-22 |