| NPI | 1891443164 |
|---|---|
| Doing Business As | TEEN RECOVERY CENTER - MADISON HIGH |
| Entity Type | Organization |
| Authorized Contact | JAMES C CALLAGHAN President/CEO 858-573-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-03-15 |