| NPI | 1902589013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HUNTER Program Administrator 949-500-7286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |