| NPI | 1023279056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MAR CEO 909-771-8023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A87348) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA A87348) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2011-11-18 |