| NPI | 1992384663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM WADE CEO 661-706-8898 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-05-20 |