| NPI | 1912358904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA MYSHAWN HICKS Lvn Nurse 323-653-1677 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: CA VN228146) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-06-30 |