| NPI | 1528701976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE TILMAN Executive Director 408-505-1873 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |