| NPI | 1508195959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH A PROCOPIO CEO 949-432-4622 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: CT CCF-155) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: CT CCF-155) | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2022-10-16 |