| NPI | 1689329922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALLACE DE ROTHSMAN CEO 650-797-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-04-06 |