| NPI | 1962861369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON SHULTS Program Manager 707-484-1326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |