| NPI | 1497507453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEEN BHEEMANATHINI Owner 818-472-1727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-04-03 |