| NPI | 1538459060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY TICHELAAR President 951-695-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 330100AP) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2020-02-26 |