| NPI | 1811383227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD HONN Program Administrator 909-233-5634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2015-11-30 |