| NPI | 1912423385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WILSON Program Director 949-344-2742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-17 |