Organization Name: | ACADIA MALIBU, INC. |
NPI Number: | 1205202926 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EVAN HAINES (CO-FOUNDER) |
Mailing Address: | 28955 Pacific Coast Hwy Ste 210 Malibu |
State: | CA US |
Postal Code: | 902653930 |
Phone Number: | 3109755344 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2015 |
NPI Last Update Date: | 08/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 190786BP |
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: |