| NPI | 1821263922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON ALBERT HOLM Alcohol Or Other Drug Counselor 909-592-6897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-06-17 |