| NPI | 1063768091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA PANNIZON Assistant Program Director 619-542-4156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: CA 390200000) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |