NPI | 1306543962 |
---|---|
Entity Type | Organization |
Authorized Contact | TYLER MICHAELIS CEO 949-606-4681 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2023-02-14 |
Last Update Date | 2023-02-14 |