| NPI | 1568711216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R BERNHARDT Clinical Director 818-720-3744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: Certif # 1-003-1089) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |