| NPI | 1669602843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRLETICH Qa 951-565-8144 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: CA 3364033240) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |