| NPI | 1699891697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRELL TIDWELL Executive Director 310-900-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: CA 930000157) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-02-06 |