| NPI | 1700245842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPARKY HARLAN Executive Director 408-243-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 435202096) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA 435202096) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2022-03-15 |