| NPI | 1558188987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDAN BOONE WILDER CEO 831-332-3854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-09-25 |