| NPI | 1104293141 |
|---|---|
| Doing Business As | MINI HOUSE RESIDENTIAL TREATMENT |
| Entity Type | Organization |
| Authorized Contact | VERA MARTINEZ Program COO Rdinator 323-813-0200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0800X Clinic/Center Recovery Care (Licence: CA 190718AN) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2016-06-08 |