NPI | 1073887329 |
---|---|
Doing Business As | LA FUENTE HOLLYWOOD TREATMENT CENTER |
Entity Type | Organization |
Authorized Contact | MANUEL RODRIGUEZ Executive Director 323-464-2947 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190725AP) |
Enumeration Date | 2012-03-05 |
Last Update Date | 2012-03-05 |