| NPI | 1871899765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY HAVILLAND Mft Supervisor 310-316-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2011-02-10 |