| NPI | 1962118661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ROBERT SHERMAN Director Of Compliance 949-670-6864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-01-25 |