| NPI | 1285450494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LEE Admin 949-359-5669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |