| NPI | 1336531342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEILANI CABUDOL Credentialing/Intake 877-991-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ZZ 1-14-16102) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-02-27 |