| NPI | 1174249189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH THOMPSON Chief Legal And Development Officer 949-462-4622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2025-08-14 |