| NPI | 1740945245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY RUSHING Licensed Clinical Social Worker 209-217-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2023-10-06 |