| NPI | 1295253300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORNA PHAM Compliance Officer 949-237-0893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2022-07-21 |