| NPI | 1881710887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM SORG It Director 818-654-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-12-22 |