| NPI | 1174040208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BLOOM CEO 818-207-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: CA 11299) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-07-21 |