| NPI | 1811173792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE BIBBY Administrator 760-342-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 3300101120) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-10 |