| NPI | 1578003711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA DEROSE Director 916-965-5135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA 347004337) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-07 |