| NPI | 1669528097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP HERSCHMAN Otp Division President 760-918-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: KS 380) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |