| NPI | 1912551144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARARAT ALEX YARIJANIAN CEO 310-405-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 302F00000X Exclusive Provider Organization | |
| 302R00000X Health Maintenance Organization | |
| 252Y00000X Early Intervention Provider Agency | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |