| NPI | 1487843876 |
|---|---|
| Former Legal Business Name | PROTOTYPES OBHS WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | VITKA EISEN President And CEO 213-542-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2017-08-22 |