NPI | 1316553019 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON BRAZELL COO 310-619-3491 |
Organization Subpart ? | No |
Primary Taxonomy | 283Q00000X Psychiatric Hospital |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2020-09-17 |
Last Update Date | 2022-06-08 |