| NPI | 1053724716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISMAIL JADALLAH Administrator 949-381-9159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2026-05-28 |