| NPI | 1184088023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRA VAKKAS Owner 310-883-4125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 37PC00439800) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-06 |