NPI | 1134500507 |
---|---|
Doing Business As | CENTER FOR DISCOVERY, SOUTHPORT RTC |
Entity Type | Organization |
Authorized Contact | MAGDALEN GUSTILO Director Of Payer Relations 714-568-7667 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
Enumeration Date | 2015-06-11 |
Last Update Date | 2023-11-02 |