| NPI | 1225474349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY MONIQUE WADLINGTON Owner/President 323-497-2557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA Psy20509) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |