NPI | 1679148175 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBIN JACOME Sr. Business Director 951-201-5914 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Enumeration Date | 2021-05-26 |
Last Update Date | 2021-05-26 |