Provider First Line Business Practice Location Address:
EARLY CHILDHOOD MENTAL HEALTH PROGRAM: 200 24TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94804-1804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-412-9200
Provider Business Practice Location Address Fax Number:
510-412-9248
Provider Enumeration Date:
03/26/2007