| NPI | 1407786528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYLAND JORDAN CEO 619-592-3558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-05-20 |
| Last Update Date | 2026-05-22 |