| NPI | 1023700085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANISLAV KOLBASOV CEO, CFO, Secretary 949-212-8114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2023-07-08 |