| NPI | 1902445331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK L. SMITH Medical Director 951-551-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-01-02 |