| NPI | 1609357979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MALACH Owner 951-966-6151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181602104) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |