| NPI | 1639571599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR TOLENTINO Consultant 310-272-6730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |