| NPI | 1952504508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA PORTEOUS Chief Compliance Officer 909-388-0882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA zzz74743z) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2019-06-18 |