| NPI | 1992489595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA DRAKE Administrator 661-305-0265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-10-24 |