| NPI | 1477051761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXXIS KYLA AMES Insurance Manager 424-330-0396 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190831CP) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2021-01-19 |