| NPI | 1578148664 |
|---|---|
| Other Name | MIRA MASUKAWA |
| Entity Type | Organization |
| Authorized Contact | MIRA MASUKAWA Owner 951-375-7485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-03-10 |