| NPI | 1437684172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA AUTUMN SMITH Insurance Administrator 408-460-9984 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 430053AP) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2023-06-23 |