| NPI | 1225527427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARIE REAL Owner 661-713-3532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A106346) |
| 251S00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |