| NPI | 1619450186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN T. DESIMONE Program Director 626-808-0335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |