| NPI | 1356167654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDRY HAMPTON CEO 310-505-9383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 342000000X |
| Additional Taxonomies | 103TE1100X Psychologist Exercise & Sports |
| 177F00000X Lodging | |
| 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |