| NPI | 1245580034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD D WARD Executive Director 9496-455-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300112BN) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |