| NPI | 1003649468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONSINETTA DELORES GREEN Clinical Site Manager 951-329-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-08-21 |