| NPI | 1538781190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE SUZANNE KOONIN Director 619-496-7822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-17 |
| Last Update Date | 2020-05-17 |