| NPI | 1629851258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA NICHOLE CERRILLO CEO 209-416-4866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-10-12 |