| NPI | 1063058022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA GRIMES Owner 818-599-5774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2020-01-02 |