| NPI | 1043949456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAILY ELEANOR GOUGER Outpatient Program Director 949-234-6587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2023-10-06 |