| NPI | 1770006447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAWNE FLUCKER Owner 949-600-0754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2022-07-21 |