| NPI | 1902237209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW EDWARDS Billing Manager 754-201-3980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190790AP) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |