| NPI | 1235268194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF RADANT Administrator 310-472-3728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CA 13192) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2016-03-14 |