| NPI | 1063891596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN WALLACE CEO 818-651-4594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2015-05-29 |