| NPI | 1326756701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TETYANA USTYNOVA Owner 818-308-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2025-08-21 |