| NPI | 1457173791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENA LOPEZ Provider Relations Supervisor 510-292-7024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |