| NPI | 1316206907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN C. WIKERT Administrator 760-342-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2017-01-24 |