| NPI | 1154012680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZA REIS Program Manager 760-744-3672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-23 |