| NPI | 1629345590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLA LILLY Owner 949-366-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 20A4676) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2011-11-21 |