| NPI | 1457489544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE R CLARKE Director Of Operations 909-623-2774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |