MEDICARE: MARKS HOUSE, 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	323P00000X	Psychiatric Residential Treatment Facility

General Provider Information

NPI Number	:	1598298515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARKS HOUSE, LLC

Provider Business Mailing Address
First Line	:	6053 BRISTOL PKWY
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6601
Country	:	US
Telephone Number	:	323-364-6489
Fax Number	:	310-919-0372

Provider Business Practice Location Address
First Line	:	3821 MARKS RD
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-3648
Country	:	US
Telephone Number	:	323-880-2110
Fax Number	:	310-919-0372

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	MR. TERRY SCHOSER
Credential	:
Telephone Number	:	323-880-2110

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	01/14/2026

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