| NPI | 1033410113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY VIERRA Director 909-869-2760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 261QOOOX) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |