| NPI | 1811183858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HENRY BULLOCK Psychotherapist 562-493-1496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA LCS5735) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |