| NPI | 1083251532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENYS SLESARENKO CEO 310-659-7867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2025-02-05 |