| NPI | 1811106214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS PATRICK HAGERTY Wraparound Facilitator 661-259-9439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA IMF 53401) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |