| NPI | 1396383022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HEIM Director 949-274-9627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 251V00000X Voluntary or Charitable | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-12 |