| NPI | 1790228815 |
|---|---|
| Doing Business As | MIRROR BEACH RECOVERY |
| Entity Type | Organization |
| Authorized Contact | GEORGE VILAGUT CEO 714-394-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |