| NPI | 1023403714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REINER VINCENT NUSBAUM Administrator 949-235-8258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300306AP) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 300306AP) |
| 101YM0800X Counselor Mental Health (Licence: CA 300306AP) | |
| 101YP2500X Counselor Professional (Licence: CA 300306AP) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |