| NPI | 1558015248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM CORTLAND GREEN Owner 949-397-0658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |