| NPI | 1144046475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDON EHTESHAMZADEH Co Owner 951-205-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |