| NPI | 1619712726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELICA D MANZO Executive Director 909-710-3055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |