| NPI | 1790142933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIAN N TACKETT Owner/Clinical Director 310-567-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |