| NPI | 1164812210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT CLARKE Administrator 714-361-6760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 40415) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |