MEDICARE: MULHOLLAND HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1124914973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULHOLLAND HEALTH LLC

Provider Business Mailing Address
First Line	:	20555 DEVONSHIRE ST # 448
Second Line	:
City	:	CHATSWORTH
State	:	CA
Zip	:	91311-3208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3375 COCHRAN ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2528
Country	:	US
Telephone Number	:	805-410-0056
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	RYELY OHOP
Credential	:
Telephone Number	:	805-410-0056

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	12/11/2025

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