| NPI | 1932437365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN DORIS BUCKLEY Clinical Supervisor 805-341-5735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 30759) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CA 50015) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2009-11-23 |