NPI | 1063020717 |
---|---|
Entity Type | Organization |
Authorized Contact | PHILLIP TARDANICO President/CEO 760-217-9527 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2020-07-20 |
Last Update Date | 2021-11-23 |