| NPI | 1730649674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL F RADKE Treasurer 310-641-0870 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-04-11 |