NPI | 1649752627 |
---|---|
Entity Type | Organization |
Authorized Contact | DESERIE TSOSIE Credentialing Specialist 661-673-6726 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2018-09-05 |
Last Update Date | 2018-09-05 |