| NPI | 1679320832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ETHRIDGE Psychologist/Inte RN 951-531-6785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| 251S00000X Community/Behavioral Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2024-12-28 |