| NPI | 1457068983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN A PHILLIPS Executive Director 707-399-9190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-03 |