| NPI | 1841575099 |
|---|---|
| Other Name | WINGS OF RECOVERY-SUSAN MILLER DORSEY 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 |