| NPI | 1184105488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA PORTEOUS Chief Compliance Officer 909-388-0882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-10-31 |