| NPI | 1578990644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MARTREICE FERGUSON Director 310-420-3512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA LCS14553) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |