| NPI | 1609697168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN POWELL Managing Partner 310-850-9092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |