| NPI | 1215479431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN ROY Billing Director 657-304-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300246EP) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2020-05-07 |