| NPI | 1396461901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DUENSING Billing Manager 949-877-2419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2023-04-25 |