| NPI | 1366652836 |
|---|---|
| Other Name | ADOLESCENT ODF |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. HORN Director 760-482-4112 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-12-13 |