| NPI | 1639910201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL BLACKFORD Operations 661-917-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-06-05 |