| NPI | 1053979278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM FULLER CEO 323-336-2294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |