| NPI | 1902180193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE MURPHY Owner 510-355-7195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH3892) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH3892) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2013-06-18 |