| NPI | 1891475059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDOLPH WIETFELDT President 619-616-0706 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-24 |