| NPI | 1417641275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RUZINDANA Administrator 510-219-0714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |