| NPI | 1639202450 |
|---|---|
| Other Name | TEEN CENTER SRC |
| Entity Type | Organization |
| Authorized Contact | DENISE C HUNT Behavioral Health Director 209-525-6225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2010-03-17 |