| NPI | 1861788473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA NONE LIRA Clinic Manager 661-204-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 38-22) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |