| NPI | 1609134857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARNELL SPENCER Credentialing Manager 661-239-6923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH3985) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2025-04-18 |