| NPI | 1902589013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LEIDERMAN Program Administrator 858-395-3696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2024-10-15 |