| NPI | 1093268658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSTIN BERLOW CEO 619-894-4489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: CA G076945) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |