| NPI | 1083200307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM WADE CEO 661-706-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2022-01-10 |