| NPI | 1669681961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J DAY Business Application Manager 909-382-3080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA zzz74743z) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-13 |