| NPI | 1689088569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATIX SIBYLLE WAGNER Executive Director 310-995-7427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: TX 36904) |
| Additional Taxonomies | 251S00000X (Licence: CA psy23746) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2015-09-03 |