| NPI | 1245664127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA KRISHNA JESSICK Executive Director 949-289-2752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2018-11-20 |