| NPI | 1629804703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN ALLEN Clinician 209-906-3799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-13 |