| NPI | 1528778909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATEKA HAMPTON Administrator 415-745-0345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-30 |