| NPI | 1053166942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB EDELSTEIN Owner 949-245-8625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-04-23 |