| NPI | 1700258829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON BARSALOU Program Director 818-489-4592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2020-10-26 |