| NPI | 1902763089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANISH JAIN Chief Operating Officer 209-888-0238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2026-01-08 |
| Last Update Date | 2026-01-08 |