| NPI | 1245426782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISSIE P LE-HERMIDA Owner 619-960-9645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA LCS15235) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |