| NPI | 1164036240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CARSON CEO 657-333-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 103K00000X Behavior Analyst | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 251S00000X | |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |