| NPI | 1184122012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN TYRONE CHAMBERS Owner 310-756-9965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181050463) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |