| NPI | 1699306340 |
|---|---|
| Other Name | VIP EVERGREEN ELEMENTARY SCHOOL |
| Entity Type | Organization |
| Authorized Contact | DUSTIN SCHIADA Clinical Director 323-221-4134 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |