| NPI | 1912567983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN SPARKS Director, Managed Care Contracting 949-764-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-06-20 |