| NPI | 1649748450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES OH Owner 818-441-1096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-12-19 |