| NPI | 1124454962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL LISONBEE CEO/ President 310-629-9669 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: CA 190290CP) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |