| NPI | 1619531530 |
|---|---|
| Former Legal Business Name | LA JOLLA RECOVERY |
| Entity Type | Organization |
| Authorized Contact | DANIEL SIMONS CEO 858-877-3422 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-10-09 |