NPI | 1639668007 |
---|---|
Entity Type | Organization |
Authorized Contact | GENNADIY KOPYTOV Member 310-927-7532 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QM0850X Clinic/Center, Adult Mental Health | |
Enumeration Date | 2018-05-01 |
Last Update Date | 2024-07-29 |