| NPI | 1730671769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYNISA D SNOW Member 510-473-6062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: CA 80925) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |