| NPI | 1164111035 |
|---|---|
| Other Name | MARIA JACKSON SOLE MBR |
| Entity Type | Organization |
| Authorized Contact | MARIA JACKSON Owner 951-400-8548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker, Clinical | |
| 163WP0000X Registered Nurse, Pain Management | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 251S00000X Community/Behavioral Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |