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1336687821
LARRY MAXWELL
LOS ANGELES, CA
NPI
1336687821
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
(Licence: CA R1236821116)
Enumeration Date
2017-02-06
Last Update Date
2017-02-06
Business Address
-- LARRY MAXWELL
4445 BURNS AVE
LOS ANGELES, CA 90029-2702
Phone number: 323-664-8940
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Mailing Address
-- LARRY MAXWELL
4445 BURNS AVE
LOS ANGELES, CA 90029
Phone number: 323-664-8940
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