| NPI | 1740525112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA DENISE WILSON Treatment Counselor 650-348-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |