NPI | 1235272196 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK HICKMAN C.E.O. 818-956-3737 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 19-138) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2015-09-28 |