| NPI | 1477171007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK DJEU Manager 510-409-1839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 133N00000X Nutritionist |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |