| NPI | 1205466265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN CORTEZ Lead Credentialing Specialist 619-781-2418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2024-03-28 |