| NPI | 1194029066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA OCHOA Chief Compliance Officer 909-388-0882 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2022-09-07 |