NPI | 1982080446 |
---|---|
Entity Type | Organization |
Authorized Contact | OLLIE NICHOLAS CLARK Executive Director 951-352-3943 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization |
Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Enumeration Date | 2015-08-07 |
Last Update Date | 2021-10-18 |