| NPI | 1932223500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HAZLEWOOD Site Coordinator 858-487-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA MFC 31074) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |