| NPI | 1295293769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW LAST Owner 619-272-1522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |