| NPI | 1356021299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JISUNG YOON Doctor 909-485-7974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-27 |