| NPI | 1790337848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN TELFORD President 949-291-1283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-09 |