| NPI | 1720392764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY B IBEABUCHI Owner 909-884-3415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 18357) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2010-08-02 |