| NPI | 1164907234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY BUELL Billing Manager 949-842-2877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2022-02-11 |