| NPI | 1578962114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J LYONS CEO 951-536-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 330127AP) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 360107BP) |
| 251S00000X (Licence: CA 330127AP) | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2016-09-20 |