NPI | 1639677768 |
---|---|
Doing Business As | BOARDWALK RECOVERY CENTER |
Entity Type | Organization |
Authorized Contact | AMANDA TAMAI Executive Assistant 619-206-0081 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
Enumeration Date | 2018-01-23 |
Last Update Date | 2018-08-15 |