| NPI | 1194561522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ANTHONY VANPORTFLIET Chief Executive Officer 619-874-8624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-07-04 |
| Last Update Date | 2024-07-04 |