| NPI | 1659654986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY HAVIG Psychiatric Nurse 909-398-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN240811) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2013-06-28 |