| NPI | 1114430469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH THOMPSON Chief Legal And Development Officer 949-432-4622 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CT 0062) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: CT 0607) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: CT 0503) | |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2025-08-15 |