| NPI | 1235677477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MADISON Owner 562-714-2146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NV NV20161704135) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NV NV20161704135) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2021-09-03 |