| NPI | 1902792997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABSALOM SHU Owner 323-532-5886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-06-16 |