| NPI | 1053771782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTEN THERESE DEVEREUX Administrator 949-200-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: CA 300636AP) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2024-03-27 |