| NPI | 1659628220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA V GRIMM Program Director 415-864-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-13 |