| NPI | 1164158218 |
|---|---|
| Former Legal Business Name | SGVGRTC |
| Entity Type | Organization |
| Authorized Contact | JASON NYHAN Executive Director 310-405-3405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 102X00000X Poetry Therapist | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 172V00000X Community Health Worker | |
| 225XM0800X Occupational Therapist, Mental Health | |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-07-29 |