| NPI | 1093223877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYLE MACKELVEY Supervisor 714-948-6086 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300315JP) |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2019-10-28 |