| NPI | 1609384551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY FIES Controller 562-498-5513 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2023-11-15 |