| NPI | 1942758909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILEY DAVID THORNE Clinical Director 650-703-9185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 430080an) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |