| NPI | 1598438046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTON ABERNETHY Billing Manager 949-397-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2021-07-30 |