| NPI | 1104379775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MALEK Administrator 626-644-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 300642AP) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2020-02-28 |