| NPI | 1689925729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WYARD Chief Executive Officer 818-898-1388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2022-02-23 |