| NPI | 1053687129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE RAE LASS President 619-533-6089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA PSy 23820) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |