| NPI | 1275886111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S MEZA Licensed Psych Tech 424-249-3873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 34614) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |