| NPI | 1073744660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA K HUGHES Chief Executive Officer 909-932-1069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 360001ABN) |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CA 36001AAN) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2023-12-28 |