| NPI | 1306640644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEDRA CREER CEO/Administrator 323-395-8594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2025-04-04 |
| Last Update Date | 2025-04-11 |