| NPI | 1740573641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BOGS Program Director 760-439-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CA ASW) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2012-08-09 |