| NPI | 1245037019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD R SHIREY Program Director 858-500-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-02-27 |
| Last Update Date | 2025-11-04 |