| NPI | 1194309765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAILY ELEANOR GOUGER Out Patient Program Director 949-228-4381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2022-10-13 |