| NPI | 1578739637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESS BOLONG Adult Caretaker 562-432-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: CA 191600093) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |