| NPI | 1942807060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MCMAHON Program Director 619-871-7345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |