| NPI | 1528200961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN REAGAN STAFFORD Director 866-660-5763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 330084AP) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |