| NPI | 1164847133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHBAH MAKOUIE Owner 310-553-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA MFC 52448) |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |