| NPI | 1720782824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH BROWN CEO 310-428-2576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| 261QH0100X Clinic/Center Health Service | |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2023-03-30 |