| NPI | 1982406179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER RIVERA Associate Manager Of Credentialing 619-977-7201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-03-26 |
| Last Update Date | 2025-03-26 |