| NPI | 1043092489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN SUKIASYAN Authorized Official 424-200-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 251B00000X Case Management | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-10-20 |