| NPI | 1174731384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE GRIFFIS Licensee 323-770-2051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2020-08-22 |