| NPI | 1366910960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CARSON CEO 657-333-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2018-11-13 |