| NPI | 1912677576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICH PORTIGAL Vice President 951-813-2597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2025-09-03 |