| NPI | 1598364887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS SCOTT BEETS Billing Director 949-933-1931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2021-06-08 |