| NPI | 1356110837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK CISNA Authorized Official 949-506-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2024-06-26 |