| NPI | 1932504024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYLE MACKELVEY Supervisor 714-948-6086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300254BP) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2019-12-18 |