| NPI | 1275318818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLU REDDY CEO 909-635-7764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 167G00000X Licensed Psychiatric Technician | |
| 207R00000X Internal Medicine | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2024-04-10 |