| NPI | 1154101384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL N SAMSON CEO 949-603-0989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2024-08-14 |