| NPI | 1932555778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ANTONIO LOPEZ Case Coordinator 707-294-7784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 11404-12) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |