| NPI | 1770222432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHANN PUDER CEO, Medical Director 909-720-2749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |