| NPI | 1639031511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIA EKOLLO Director 323-207-9940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2025-11-28 |
| Last Update Date | 2026-01-05 |