| NPI | 1568087716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE DEFONSE FANFAN Asst Administrator/Manager 323-412-2137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2020-06-13 |