| NPI | 1104570282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHADIJA HAMUCHE HAMISI CEO 909-429-3224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2024-04-23 |