| NPI | 1104905140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN B WATTS Mental Health Counselor RN 310-668-6862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CA 328506) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |