| NPI | 1447987367 |
|---|---|
| Doing Business As | LGTC - WILLOW GLEN |
| Entity Type | Organization |
| Authorized Contact | EUGENE TILMAN Director 408-559-3403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-08-02 |