| NPI | 1407463961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL L SHAW-WILSON President 323-593-6968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 251B00000X Case Management | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2022-02-11 |