| NPI | 1760941199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE GOOLSBY Lmft/Owner 909-206-4453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2020-05-21 |