| NPI | 1114697125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PRIESING President 949-300-1657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-09-20 |