| NPI | 1710632724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BUCHEGER Billing Manager 657-304-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261Q00000X |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2023-10-16 |