| NPI | 1659119857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAINA DONNER Manager 310-343-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 106H00000X Marriage & Family Therapist | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2024-07-20 |
| Last Update Date | 2024-08-07 |