| NPI | 1033093158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARIKSA MENJIVAR Owner 743-224-7107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-01 |