| NPI | 1962867804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAX PRENTISS CEO 310-589-2880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2015-12-18 |