| NPI | 1235475856 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | MARCUS DARNELL SHANNON Behavioral Counselor 619-565-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2012-12-31 |