| NPI | 1164113551 |
|---|---|
| Former Legal Business Name | CLEAN START RECOVERY INC |
| Entity Type | Organization |
| Authorized Contact | TIFARRAH EMMA WILLIAMS Executive Secretary 562-488-7046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-16 |