| NPI | 1194238097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLOE CARRASCO Administrative Assistant 714-639-5546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: CA 12139-R) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |