| NPI | 1467978817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEEBY WOODEN Owner 760-810-1440 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-17 |