| NPI | 1487275673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKECIA HIGGINBOTHAM Clinical Director 323-202-8432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-10-25 |