| NPI | 1275913436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH B DAVIS Psychologist/Clinical Director 619-540-3235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: VA 0810004027) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: VA 0810004027) |
| 261QH0100X Clinic/Center, Health Services (Licence: VA 0810004027) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2016-08-29 |