| NPI | 1619162112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE DANIELLE PERRY Executive Director 916-665-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 340076AN/BN) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-09-08 |
| Last Update Date | 2007-09-08 |