| NPI | 1972042232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS EUGENE COBB Owner 888-255-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA MFT6936) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |