| NPI | 1407052863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASONYA THOMAS Director 909-388-0801 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CA ZZZ74743Z) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2014-11-12 |