| NPI | 1710473772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GRILLO Managing Member 310-994-6411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-05 |