| NPI | 1114250040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE SCHAEFFER Account Mgr 310-328-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA BUS-0106005) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: CA BUS-0106005) |
| 261QH0700X Clinic/Center, Hearing and Speech (Licence: CA BUS-0106005) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |