| NPI | 1235439332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY DIANE TACQUARD Owner 951-764-0537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC38834) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |