| NPI | 1356981393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMAD KHATIBLOO Consultant 714-865-1769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-01-07 |