| NPI | 1740481613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA OCHOA Chief Compliance Officer 909-388-0882 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: CA ZZZ74743Z) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2023-06-23 |