PASSAGES BEVERLYWOOD LLC


Address: 2370 S Robertson Blvd, Los Angeles, CA 90034-2029
Phone: 3105892880

PASSAGES BEVERLYWOOD LLC (NPI# 1962867804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962867804
Entity Type Organization
Organization Name PASSAGES BEVERLYWOOD LLC
Practice Address 2370 S Robertson Blvd
Los Angeles
CA 90034-2029
Mailing Address 6428 Meadows Ct
Malibu
CA 90265-4492
Practice Telephone 3105892880
Practice Fax Number 3105892858
Mailing Telephone 3105892880
Mailing Fax Number 3105892858
Enumeration Date 2015-12-18
Last Update Date 2015-12-18
Authorized Official Name MR. PAX PRENTISS (CEO)
Authorized Official Telephone 3105892880
Is Organization Subpart Y
Parent Organization Name GRASSHOPPER HOUSE LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Office Location

Street Address 2370 S ROBERTSON BLVD
City LOS ANGELES
State CA
Zip Code 90034-2029

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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90034

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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