NPI | 1225759871 |
---|---|
Entity Type | Organization |
Authorized Contact | KENRICK BRIAN LICORISH Psychiatrist 949-244-0104 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-09-12 |
Last Update Date | 2022-09-12 |