| NPI | 1821662651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLIE LESSER Controller 818-889-3665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2022-10-24 |