| NPI | 1528625662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT STANFORD Partner 626-590-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2020-09-17 |