| NPI | 1558666982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY M BREAKEY Clinical Coordinator 209-334-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC30755) |
| Enumeration Date | 2011-01-15 |
| Last Update Date | 2011-01-15 |