| NPI | 1861985541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA ROSS Owner 619-366-1546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |