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LYNWOOD, CA
NPI1013494525
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-07-26
Last Update Date2018-07-26
Business Address
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11705 DEPUTY YAMAMOTO PL
LYNWOOD, CA 90262-4031
Phone number: 323-242-5000
Mailing Address
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11705 DEPUTY YAMAMOTO PL
LYNWOOD, CA 90262-4031
Phone number: 323-242-5000
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