| NPI | 1114331139 |
|---|---|
| Former Legal Business Name | CENTRAL JUVENILE HALL MENTAL HEALTH UNIT |
| Entity Type | Organization |
| Authorized Contact | MARVIN J SOUTHARD, D.S.W. Director 213-738-4601 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |