NPI | 1174193056 |
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Doing Business As | PREVENTION AND RECOVERY CENTER, CLEARLAKE IOP |
Entity Type | Organization |
Authorized Contact | MAGDALEN GUSTILO Director Of Payer Relations 714-568-7667 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
Enumeration Date | 2021-07-01 |
Last Update Date | 2023-05-08 |