| NPI | 1962173815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANISHA MICKENS Owner 310-598-8048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2021-09-21 |