| NPI | 1689797995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA YAKOVENKO Executive Director 310-666-4082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 190337BN) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |