| NPI | 1306519319 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AYNSLEY BARRIEMORE SILVA Owner 949-981-9835 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-07-26 | 
| Last Update Date | 2021-07-26 |