NPI | 1831474980 |
---|---|
Other Name | WINGS OF RECOVERY-JOHN MARSHALL HIGH SCHOOL |
Entity Type | Organization |
Authorized Contact | RENEE G MONCITO President & CEO 310-670-6767 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization |
Enumeration Date | 2011-10-19 |
Last Update Date | 2011-10-19 |