| NPI | 1386024115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARSTEN Director 323-936-3965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA LCS15899) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CA 52614) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2015-06-07 |