| NPI | 1548796931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB EUGENE JACQUEZ Owner, Executive Director 385-800-3272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2023-07-16 |