| NPI | 1528601960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENORE GAINES Owner 619-971-9626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |