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Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENNIS RYAN (MANAGING PARTNER)
(855) 762-3796
Entity
Organization

Contact information

Practice address
1857 CHURCH ST, SIMI VALLEY, CA 93065-3914
(855) 762-3796
Mailing address
2600 QUANTUM BLVD, BOYNTON BEACH, FL 33426-8627
(855) 762-3796

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
11/14/2022
Last updated
03/17/2026
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