| NPI | 1295129112 |
|---|---|
| Doing Business As | FOOTPRINTS BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS RUSSI Vice President 951-427-4807 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2016-12-23 |