| Organization Name: | CLIFFSIDE MALIBU IOP |
| NPI Number: | 1164826210 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ARIELLE PENN (UR) |
| Mailing Address: | 28990 Pacific Coast Hwy Suite 203 Malibu |
| State: | CA US |
| Postal Code: | 902653952 |
| Phone Number: | 3105892800 |
| Fax Number: | 3105892802 |
| NPI Enumeration Date: | 10/17/2014 |
| NPI Last Update Date: | 10/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 190815A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |