| NPI | 1619426673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSIE RAMOS Hr Manager 619-592-8695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 305R00000X Preferred Provider Organization (Licence: CA IMF78197) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2019-04-03 |