| NPI | 1891320099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SIMONS CEO 619-455-1318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-03-08 |
| Last Update Date | 2021-04-13 |