| NPI | 1073151015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD ROBERT DUPREZ Owner 909-987-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |