| NPI | 1710437637 |
|---|---|
| Other Name | DIMONDALE ADOLESCENT #4 |
| Entity Type | Organization |
| Authorized Contact | KENNETH FLEMING Director 310-791-3064 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA 197804638) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2019-03-15 |