| NPI | 1700403706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS MARTIN Manager 619-631-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |