| NPI | 1275124844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN GERSHMAN Chief Operating Officer 760-715-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2021-05-10 |