| NPI | 1104002146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DICKERSON Vice President 626-387-5763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2008-01-19 |
| Last Update Date | 2008-01-19 |