| NPI | 1346843901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITRA STANSIL Owner 619-244-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2020-11-17 |