| NPI | 1184290934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHEANNE COCKHREN Sole Member/ CEO 619-647-7568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |