| NPI | 1891203162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENITY BLANTON Owner 707-373-8392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |