| NPI | 1528390549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WRITH Clinical Supervisor 909-386-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA mfc30166) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-01 |