| NPI | 1861755480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BLEVINS Director 408-794-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 14707) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |