| NPI | 1215538244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDY LAI Controller 424-290-3341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |