| NPI | 1275410128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GODFREY NWOGENE Director 951-625-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-29 |