| NPI | 1710361969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN F COREY Duel Owner 626-755-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 190821AP) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |