| NPI | 1487198461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DA-LONDA GROENOW Program Manager 562-944-7953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |