| NPI | 1992465181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL CLARDY Administrator 510-290-6632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |