| NPI | 1346790524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERALEEN M PETERSON Owner 909-291-9349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS28561) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |