| NPI | 1760205199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAINA DONNER Manager 310-343-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-12-16 |