| NPI | 1346994258 |
|---|---|
| Doing Business As | MOMENTUM FOR HEALTH - LA SELVA OUTPATIENT |
| Former Legal Business Name | MOMENTUM FOR MENTAL HEALTH - LA SELVA OP IOP |
| Former Legal Business Name | ALLIANCE FOR COMMUNITY CARE - LA SELVA OP IOP |
| Entity Type | Organization |
| Authorized Contact | DAVID K. MINETA CEO 669-213-0755 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2023-02-22 |