| NPI | 1235661315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN PREMAZON Owner 714-865-1052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2019-11-26 |