| NPI | 1710442058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER GATES Cco 949-701-1959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2026-01-27 |