| NPI | 1134604069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM SHANDROW Billing Manager 562-972-3955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2020-12-15 |