| NPI | 1689030355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY D HOLLAND Residential Counselor 408-625-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA 322d00000x) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |