| NPI | 1588151484 |
|---|---|
| Former Legal Business Name | KEY MENTORING |
| Entity Type | Organization |
| Authorized Contact | RYAN BLIVAS COO 310-600-5658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |