| NPI | 1477062487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY FLYNN Insurance Director 949-419-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: KY 810588) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2017-09-22 |