| NPI | 1467265439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TER-HOVHANNISYAN EDGAR CEO 818-928-0038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-01-31 |