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