| NPI | 1285877308 |
|---|---|
| Former Legal Business Name | MOMENTUM FOR MENTAL HEALTH - FSP IMD |
| Entity Type | Organization |
| Authorized Contact | DAVID K. MINETA CEO 669-213-0755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2022-12-28 |