NPI | 1760247993 |
---|---|
Entity Type | Organization |
Authorized Contact | LATISHA A SHEPHERD Owner 909-898-7665 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2024-02-16 |
Last Update Date | 2024-02-16 |