| NPI | 1790819068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA P FARJALLA Psychiatrist 951-955-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: CA A37158) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |