| NPI | 1477929909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE R MCHENRY Program Director 657-304-0103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300246BP) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2020-05-07 |