| 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 |