NPI | 1104293141 |
---|---|
Doing Business As | MINI HOUSE RESIDENTIAL TREATMENT |
Entity Type | Organization |
Authorized Contact | VERA MARTINEZ Program Coordinator 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 |