| NPI | 1306285820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE LANZA CEO 310-503-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NM NM10059M) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2020-05-13 |