| NPI | 1902534274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA S DAVIES Program Manager 310-721-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2023-01-18 |