| NPI | 1356725808 |
|---|---|
| Other Name | AVERY'S HEROES |
| Entity Type | Organization |
| Authorized Contact | LYNDEE VENOSTA Manager 760-805-4127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PSY24897) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96181) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2017-01-06 |