| NPI | 1770968513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT CHRISTIAN KALLAND Owner/President 949-525-7977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2019-07-02 |