| NPI | 1780384412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THUONG-PHUONG ARVID NGUYEN Provider 562-200-0254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2023-03-22 |