| NPI | 1821261207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY SHAKIR Program Administrator 310-677-9019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 90318188) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |