| NPI | 1801489588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R JACKSON-ZENO Medical Billing Project Coordinator 310-686-6092 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2021-02-14 |
| Last Update Date | 2024-08-21 |