| NPI | 1790425247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJA ROLEY Clinical Director 949-474-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |