| NPI | 1245553700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN DOUGLAS THIEM Counselor 951-600-6360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 330023DN) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |