| NPI | 1114549144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY JO DORSEY Executive Director/COO 951-221-1805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |