| NPI | 1669240842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI MAHMOOD KHAN Owner 408-838-1189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |