| NPI | 1295460707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELANA LISCH Director Of Clinical Operations 909-442-0618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2023-01-18 |