| NPI | 1376987701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS MANESS Owner 858-735-4888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: CA 2457 BCN) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 2457 BCN) |
| 103K00000X Behavior Analyst (Licence: CA 2457 BCN) | |
| 175F00000X Naturopath (Licence: CA 2457 BCN) | |
| 174400000X Specialist (Licence: CA 2457 BCN) | |
| 103T00000X Psychologist (Licence: CA 2457 BCN) | |
| 111NR0400X (Licence: CA 2457 BCN) | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-06-06 |