| NPI | 1497385892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADIYA ALASOW Admin 858-216-5617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2020-01-24 |