| NPI | 1013556471 |
|---|---|
| Doing Business As | LONG BEACH RESIDENTIAL |
| Entity Type | Organization |
| Authorized Contact | TEODULO BONZON Administrator 818-846-4469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |