| NPI | 1619210291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK W. GAINES President 818-981-4030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA c14269) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-04-01 |