| NPI | 1306455126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LACHELLE SMITH Owner 562-743-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2024-02-26 |