NPI | 1407458490 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLEY MADDOX-WASINGTON Licensed Professional Counselor 951-956-8100 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2020-11-13 |
Last Update Date | 2020-11-13 |