| NPI | 1912768615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERISSE HUNTER-SOUTHERN Director 951-250-8852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |