| NPI | 1508083205 |
|---|---|
| Former Legal Business Name | MOMENTUM FOR MENTAL HEALTH - EASTSIDE |
| Former Legal Business Name | ALLIANCE FOR COMMUNITY CARE - EASTSIDE |
| Doing Business As | MOMENTUM FOR HEALTH - EASTSIDE OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | DAVID K. MINETA CEO 669-213-0755 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-02-22 |