| NPI | 1336780774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY NGENE Lvn 310-590-8740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-07 |