| NPI | 1184384216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KENNETH MATHIAS Chief Executive Officer 909-948-5747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-30 |
| Last Update Date | 2022-08-05 |