| NPI | 1588424519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY BROSCH Chief Operating Officer 949-257-9128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-11-13 |