| NPI | 1275020554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LEE GAUTHIER Owner 310-497-6176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 55232) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 55232) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11589) | |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2019-06-11 |