| NPI | 1457550238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE FERNANDEZ Director, Cpg Business Services 415-206-8969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2024-04-02 |