| NPI | 1790183432 |
|---|---|
| Other Name | 1370 OUTPATIENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | DIANA STORNETTA Supervising Accountant 707-565-4833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2015-01-16 |