| NPI | 1881241776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ROBERT PAGE CEO 209-800-4573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2023-11-27 |