| NPI | 1225425705 |
|---|---|
| Doing Business As | INNOVATION 360 |
| Entity Type | Organization |
| Authorized Contact | KEVIN GILLILAND Executive Director 626-427-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |