| NPI | 1811990377 |
|---|---|
| Other Name | GRANCELL VILLAGE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARY M FORREST Chief Executive Officer 818-774-3208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 960000819) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2018-07-02 |