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