| NPI | 1851711881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KENNETH RUSSELL President 562-799-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA psy4430) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |