| NPI | 1003600511 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | MIRACLE D MONTGOMERY Licensed Clinical Social Worker 310-849-4786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-04-08 |