| NPI | 1790481901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARON DANIEL HAYNES Owner 619-395-3657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-06-09 |