| NPI | 1295301950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BUCHEGER Billing Director 657-304-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-07-15 |