| NPI | 1629465273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEBASTINE E. CHIKEZIE Nurse Practitioner 310-982-3141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA 688400) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: CA 688400) |
| 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: CA 688400) | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |