| NPI | 1508987652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN F. PETTUS CEO 510-835-9610 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2017-05-17 |