| NPI | 1225457500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE HUDZIK Mental Health Provider 858-945-5074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 149015920) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 149015920) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |