| NPI | 1902645112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA C HARRISON Secretary 209-213-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-10-01 |