| NPI | 1063200772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS MOORE Managing Member 323-394-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-05-27 |