| NPI | 1144571290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH HAMILTON Executive Director 323-777-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190182BN) |
| Additional Taxonomies | 251C00000X (Licence: CA 190182BN) |
| 305S00000X Point of Service (Licence: CA 190182BN) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 190182BN) | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |