| NPI | 1295110674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CUSACK CFO 323-646-9271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 283Q00000X Psychiatric Hospital | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2016-06-15 |