| NPI | 1790008258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN SOUTHARD Director Of Mental Health 213-430-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: WA MANTELA352PR) |
| Additional Taxonomies | 251E00000X Home Health (Licence: AZ D05195986) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |