| NPI | 1932648086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRNA BASSAM Clinical Director 551-800-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 11314553) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2026-03-26 |