| NPI | 1225063704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY J LUNDBERG Licensed Clinical Social Worker 562-826-5759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center VA (Licence: CA LCS19256) |
| Additional Taxonomies | 273Y00000X Rehabilitation Unit (Licence: CA LCS19256) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |