| NPI | 1164197869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK DAVID QUINDT Owner 760-215-1844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2021-08-13 |