NPI | 1104408780 |
---|---|
Doing Business As | IMMERSIVE WELLNESS CENTERS |
Entity Type | Organization |
Authorized Contact | ANGELA MCMAHON COO 619-871-7345 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2021-04-23 |
Last Update Date | 2021-04-23 |