| NPI | 1215488002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SIMMONS Program Director 949-929-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2017-10-26 |