| NPI | 1548389364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINA BOUGH Administrator 916-806-2031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |