| NPI | 1902695422 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JEFFERY CONROY Owner 949-280-8360 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | 
| Enumeration Date | 2025-05-01 | 
| Last Update Date | 2025-05-01 |