| NPI | 1861037087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH REBECCA BALES Managing Clinician 323-480-3710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2021-05-10 |