| NPI | 1215360060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILLAIN SCHULMAN Program Superviosor 760-438-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 1-09-6536) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-09-03 |