| NPI | 1821395757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DE'WANN WHITE Behavioral Health Specialist Ii 909-419-9094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2011-02-11 |