| NPI | 1609367515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENDA DIONNE MADRIGAL President 909-262-8325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: CA PSY14246) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA PSY14246) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA PSY14246) | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-10-25 |