| NPI | 1457829236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUMIDE ILEMOBOLA IJISHAKIN Administrator 323-363-8489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-09 |