| NPI | 1962117440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDSON LEA COO 619-841-1310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 208D00000X General Practice | |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2026-05-06 |