NPI | 1922652296 |
---|---|
Doing Business As | THE LAKE IOP |
Entity Type | Organization |
Authorized Contact | AMY CRICHTON Executive Director 760-200-3839 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2019-07-25 |
Last Update Date | 2019-07-25 |