| NPI | 1104826072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALONZO MITCHELL CEO 714-839-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA 300120BN) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA 300120AN) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2020-08-22 |