| NPI | 1629552542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON VAUGHN SHOEMAKER CEO 310-795-4066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2023-09-06 |