| NPI | 1831836667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY N AMUNDSON Compliance 760-343-5759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2023-09-29 |