| NPI | 1417841073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT OSBORN Medi Cal Site Cert. COO Rdinator 510-520-0943 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-06-06 |
| Last Update Date | 2025-06-06 |