| NPI | 1376013144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY HOYT Owner 619-203-5336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1000X Clinic/Center, Migrant Health | |
| 261QR1300X Clinic/Center, Rural Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-06 |