| NPI | 1306392709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAKAISHA TOLBERT-BANKS CEO/Clinical Provider 323-977-8570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IN 34006733A) |
| Enumeration Date | 2016-08-27 |
| Last Update Date | 2016-08-27 |