| NPI | 1316570005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN LONG Owner 949-617-0252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2023-02-10 |