| NPI | 1588283162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE TILMAN Secretary / Manager 408-559-3403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-06-16 |