| NPI | 1639526288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REESE CLARK Clinical Director 707-322-1903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |