| NPI | 1659670008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THESIA NICHELLE DAVIS Program Supervisor 415-507-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2022-07-21 |