| NPI | 1265194203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHANA LEWIS CEO 909-570-1172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2021-10-07 |