| NPI | 1114763851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY HUNTER Program Manager 949-678-3214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-07-12 |