| NPI | 1194252759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE HAVENS Owner 619-356-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-15-21047) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2025-10-29 |