| NPI | 1992397020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVACKUS DAWSON Director 213-924-5275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |