Organization
BILL WILSON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPARKY HARLAN (EXECUTIVE DIRECTOR)
(408) 243-0222
Entity
Organization
Contact information
Practice address
509 VIEW ST, MOUNTAIN VIEW, CA 94041-2041
(408) 278-2588
Mailing address
3490 THE ALAMEDA, SANTA CLARA, CA 95050-4333
(408) 243-0222
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
435202096
CA
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
435202096
CA
Other
Enumeration date
02/17/2016
Last updated
03/15/2022
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