| NPI | 1689261265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ELLIS CEO 909-576-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2020-12-29 |