| NPI | 1053914614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARNELL SPENCER Credentialing Manager 661-239-6923 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2025-06-05 |