| NPI | 1467124388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BUCHEGER Billing Manager 657-304-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-09-29 |