| NPI | 1932764149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENESSA MARIE SARGENT CEO 951-369-5282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |