| NPI | 1629461223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY STEPHENSON Chief Executive Officer 310-579-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190067AP) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190836AP) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2019-03-11 |