| NPI | 1154479517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL J ANTONIOU Credentialing Services Manager 805-413-1318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |