| NPI | 1942562665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDYE TINSON Mft I 619-944-7148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV MI0351) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2012-06-08 |