NPI | 1982975009 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES ELLIS President 909-576-2224 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5980-C) |
Enumeration Date | 2012-01-20 |
Last Update Date | 2018-06-20 |