| NPI | 1992913107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTO DAVID Licensee 310-391-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 960000788) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2020-08-22 |