| NPI | 1922518547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER MARTIN PANAMENO CAMPOS Chief Executive Officer 909-782-8382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 26127) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |