| NPI | 1669841490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUITA S. SUGGS Clinical Director 323-778-7965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW20459) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CA LCSW20459) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |