| NPI | 1447876123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R YBARRA Administrative Director 909-777-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |