| NPI | 1710403407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R YBARRA Administrative Director 909-777-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2017-08-15 |