| NPI | 1023463999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN SPENCER Program Manager 949-678-3014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 300121IN) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |