| NPI | 1922531839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENA LOPEZ Provider Relations Supervisor 510-337-7950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-08-14 |