| NPI | 1194238881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVESTER LA SHAWN WALTERS Co Owner 626-318-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2017-11-16 |