| NPI | 1790422319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAR POE ROBINSON Credentialing Specialist 415-912-0987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-05-16 |