| NPI | 1205426541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RISHI KHATRI Attorney 310-896-5183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-01-20 |