| NPI | 1821200551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKIDA JONES Administrator 310-843-0246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 190330BP) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 190330AP) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |