| NPI | 1922772144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MERTENS CEO 209-754-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-08-02 |