| NPI | 1922873694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTENA WILSON CEO 760-459-9790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2023-11-22 |