| NPI | 1245690668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROBINSON KELTNER President Owner 619-838-0519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA A71514) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A71514) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-04-24 |