| NPI | 1699560078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES BLANCO Secretary 909-589-4055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-14 |