| NPI | 1245814151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW DAHLSTEDT CFO/COO 619-694-6809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2021-05-06 |