| NPI | 1871758896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN BLEVINS Therapeutic Service Manager 408-293-0422 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2008-07-21 |