| NPI | 1528393964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA TABRIZY Clinical Director 949-837-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CA MFC31490) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2019-07-16 |