| NPI | 1942823471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS A RAMIREZ CEO 909-658-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-06-04 |