| NPI | 1467022665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH HEACOCK President 408-461-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |