| NPI | 1740879469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI DUDGEON Owner 949-836-2451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-01-17 |
| Last Update Date | 2021-10-16 |