| NPI | 1306072426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARRIS RICHARD WALAYAT Chairman 909-796-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA A97080) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A97080) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2012-03-12 |