| NPI | 1144668468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SMITH Executive Director 714-392-7306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2013-06-08 |
| Last Update Date | 2013-06-08 |