| NPI | 1760351100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADAF Z. FOROUHAR Clinical Supervisor 310-429-7558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |