| NPI | 1184013781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATE IZZO Office Manager 949-419-4929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 370143AP) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2019-03-19 |