| NPI | 1992437164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DASIA DUNN Board Member 619-339-3049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |