| NPI | 1801348362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMYLAH MIMS Manager 310-461-5576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |