| NPI | 1992901466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. DAY Information Technology Manager 909-388-0570 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: CA ZZZ74743Z) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2007-07-13 |