| NPI | 1912367160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS JEFFERY LEE Owner 619-944-8293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA LMFT86487) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2018-06-20 |