| NPI | 1134017692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIRSA VAZQUEZ Owner 949-738-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-08-26 |