NPI | 1013246222 |
---|---|
Doing Business As | GREEN WELLS EECP |
Entity Type | Organization |
Authorized Contact | JARED JASON WELLS Owner/Chief Techician 310-405-1478 |
Organization Subpart ? | No |
Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
Enumeration Date | 2009-12-17 |
Last Update Date | 2009-12-17 |