| NPI | 1730847286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PARK Supervisor 949-891-5336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2024-11-13 |