| NPI | 1679251441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY CLARK Director 714-655-5371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |