| NPI | 1720883325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS O'KEITH Owner 310-930-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |