| NPI | 1851898811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEE MANDERSON Owner 949-294-9974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300027AP) |
| Additional Taxonomies | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CA 300027BP) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |