| NPI | 1073854147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LEWIS CFO 888-948-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 198207997) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2024-03-31 |