| NPI | 1982853305 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | DEBORAH LICURSE Director 408-774-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 42830) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-09-10 |