| NPI | 1396695698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LAUREN BACA Administrative Supervisor 909-381-3774 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2026-01-28 |
| Last Update Date | 2026-02-04 |