| NPI | 1104686708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY HINSON Authorized Official 949-506-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2025-01-23 |