| NPI | 1689187288 |
|---|---|
| Other Name | VIP WOODROW WILSON SENIOR HIGH SCHOOL |
| Entity Type | Organization |
| Authorized Contact | DUSTIN SCHIADA Clinical Director 323-221-4134 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |