| NPI | 1770228421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUISANA ELIAS Program Operations Manager 619-450-6532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 103T00000X Psychologist |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-04-27 |