| NPI | 1659980290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTEN DEVEREUX Administrator 949-200-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 1041C0700X Social Worker, Clinical | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-03-07 |