| NPI | 1548958598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LEE Administrator 619-987-8078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2024-11-20 |