| NPI | 1912235573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA PORTEOUS Chief Compliance Officer 909-388-0882 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2019-06-18 |