| NPI | 1700955812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BLACK-COYNE Executive Director 800-939-6636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 30007GN) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2025-07-15 |