| NPI | 1497626337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAINE ROBERT LEE President / Owner 714-325-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-15 |