| NPI | 1831602291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYATTA WEATHERSBY Management 909-269-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171598675) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |