| NPI | 1821110115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JORDAN Program Manager 323-778-4227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 2395299) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 101YA0400X) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 101Y0000X) | |
| 251B00000X Case Management (Licence: CA 2395299) | |
| 251B00000X Case Management (Licence: CA 251300000x) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |