| NPI | 1952546400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA WILSON CEO 951-677-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: CA 330911240) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CA 330911240) |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 330911240) | |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |