| NPI | 1528519659 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MITCH SHAFFER Program Director 949-333-1209 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2016-10-24 | 
| Last Update Date | 2016-10-24 |