| NPI | 1093113383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN WALLACE CEO 818-651-4594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 538463) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |