| NPI | 1780958025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY HUMPHREYS Program Director 626-893-5046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 1-11-8431) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |