| NPI | 1386118180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYLE LEE MACKELVEY Supervisor 714-948-6086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |