| NPI | 1679033260 |
|---|---|
| Doing Business As | MENTAL HEALTH-NYSTROM |
| Entity Type | Organization |
| Authorized Contact | DONALD BRUCE BLASKY Chief Program Officer 415-755-2311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2021-08-02 |