| NPI | 1538714746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY DOSS Program Administrator 949-388-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |