| NPI | 1972351716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN TABIBIAN Manager 310-927-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2025-01-23 |