NPI | 1972301927 |
---|---|
Entity Type | Organization |
Authorized Contact | TRAVIS CHAMBERLIN TYLER Chief Compliance Officer 760-305-7528 |
Organization Subpart ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2025-03-05 |
Last Update Date | 2025-03-05 |