| NPI | 1922337864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE LEE KEPLER HOFFMAN Mft 707-645-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA MFC 47228) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA MFC 47228) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2009-12-23 |