| NPI | 1013426816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN ROY Billing Director 949-335-7598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300326DP) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2020-05-20 |