| NPI | 1235750977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMAN V MARIN Program Director 323-899-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |