| NPI | 1801555297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEAIRA COFFIN Collections Manager 949-612-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2021-12-13 |