| NPI | 1386280899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY STEVEN BLAKE Director Of Operations 818-956-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-11-19 |