| NPI | 1083101661 |
|---|---|
| Doing Business As | LA FUENTE HOLLYWOOD TREATMENT CENTER OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | MANUEL RODRIGUEZ CEO 323-464-2947 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |