| NPI | 1629767207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA CARILLO Administrator 310-251-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 174200000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |