| NPI | 1760665582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESTER JACKSON OUDNEY Program Director 310-549-5532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2007-12-14 |