| NPI | 1902110158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM OFFERDAHL Owner 949-525-3696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 970117) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2013-01-04 |