NPI | 1013555069 |
---|---|
Doing Business As | DESTINATIONS FOR TEENS |
Entity Type | Organization |
Authorized Contact | DANIEL A SAMSON Owner/President 818-737-2221 |
Organization Subpart ? | Yes |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2019-12-19 |
Last Update Date | 2024-01-18 |