| NPI | 1639907272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN YOUNG Manager 310-343-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-08-07 |