| NPI | 1619419686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLWIN H SIMANJUNTAK Treasurer 949-385-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |