| NPI | 1790672228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE AJAND Admin 323-818-7018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-06-18 |