| NPI | 1720542574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE OU Therapist 626-268-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2021-04-26 |