| NPI | 1134645716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYLE MACKELVEY Supervisor 714-948-6086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2024-11-19 |