| NPI | 1790325694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY ANGELO President / Principle 707-395-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 251S00000X Community/Behavioral Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |