| NPI | 1962829945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC LEWISON Owner/President 619-818-8106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20071612296) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2019-01-28 |