| NPI | 1508130808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TUCKER CEO 714-841-1906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 300190AP) |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CA 300190AP) |
| Enumeration Date | 2012-03-04 |
| Last Update Date | 2014-01-20 |