| NPI | 1811618051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN EZENWA Organizer 949-690-2305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |