Organization
CANYON OAKS YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM R. HOLECHEK LCSW (RESIDENTAL COUNSELOR RELIEF)
(650) 839-1810
Entity
Organization
Contact information
Practice address
400 EDMONDS RD, REDWOOD CITY, CA 94062-3803
(650) 839-1810
Mailing address
9031 CASTLEWOOD ST, OAKLAND, CA 94605-4407
(510) 213-2592
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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