| NPI | 1699378091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRANDY HESTER CEO 408-687-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2021-03-11 |