Organization
FAMILY YOUTH ROUNDTABLE OF SAN DIEGO COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA EWING MARTO (EXECUTIVE DIRECTOR)
(619) 546-5852
Entity
Organization
Contact information
Practice address
345 15TH ST, SUITE A, SAN DIEGO, CA 92101-8951
(619) 546-5852
(619) 546-6251
Mailing address
345 15TH ST, SUITE A, SAN DIEGO, CA 92101-8951
(619) 546-5852
(619) 546-6251
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
45174
CA
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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