| NPI | 1144064775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY LIND GUSTAVESON President 619-636-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-12-13 |