| NPI | 1184367344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOMAD GAWIDO CEO/Owner 619-488-7854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2022-04-15 |