| NPI | 1053006569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN YOUNG Manager 310-343-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-06-20 |