| NPI | 1598208696 |
|---|---|
| Other Name | PACIFIC LODGE CAMPUS |
| Entity Type | Organization |
| Authorized Contact | TODD SOSNA Chief Executive Officer 323-443-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: CA 198209477) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2023-05-18 |