| NPI | 1285414573 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | CHARLES LOCKETT Owner 323-251-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 177F00000X Lodging |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-10-03 |