| NPI | 1962058529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CUSACK COO 818-960-6830 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 283Q00000X Psychiatric Hospital | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |