| NPI | 1477324853 |
|---|---|
| Doing Business As | VILLA MARIA DETOX |
| Entity Type | Organization |
| Authorized Contact | SOON BURNAM Treasurer 949-540-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-01-12 |