| NPI | 1861939365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BLAIRE SHAWHAN Owner 408-879-7581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 430068AP) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |