| NPI | 1093189839 |
|---|---|
| Former Legal Business Name | ST. GEORGE DETOX HOSPITAL |
| Entity Type | Organization |
| Authorized Contact | ARLEN BARKSDALE Owner 760-533-8714 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 284300000X Special Hospital (Licence: UT 2014-HOSP-UT000586) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |