| NPI | 1497414379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM WADE Executive Director 661-706-8898 |
| Organization Subpart ? | |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2024-04-30 |