| NPI | 1265637524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA PORTEOUS Chief Compliance Officer 909-388-0882 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2019-06-18 |