NPI | 1053666024 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER JAMES BATHUM Chief Executive Officer 818-635-9380 |
Organization Subpart ? | No |
Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA BA33452) |
Enumeration Date | 2012-07-17 |
Last Update Date | 2012-07-17 |