| NPI | 1932972247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB OLSEN CEO 562-833-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2024-01-04 |