| NPI | 1962117440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LOUIS KERSHNER Manager 619-841-1310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-01-18 |