| NPI | 1528632882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN SOMMER Program Director 657-493-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-05-19 |