| NPI | 1023526209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MORENO Program Director 213-739-9982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 190039AP) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-10-10 |