| NPI | 1154059657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA BALLOU-HARDING Owner 310-650-0545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2022-08-11 |