| NPI | 1639466329 |
|---|---|
| Other Name | WINGS OF RECOVERY-CRENSHAW HIGH SCHOOL |
| Entity Type | Organization |
| Authorized Contact | RENEE G MONCITO President & CEO 310-709-8977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2011-07-01 |