MEDICARE: THE HAMILTON CENTER FOR MENTAL AND BEHAVIORAL HEALTH SERVICES, 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	261QM1300X	Multi-Specialty Clinic/Center
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1700441359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HAMILTON CENTER FOR MENTAL AND BEHAVIORAL HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	23679 CALABASAS RD STE 954
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 WIGWAM PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-8164
Country	:	US
Telephone Number	:	833-288-4764
Fax Number	:

Authorized Official
Title or Position	:	CEO/EXECUTIVE DIRECTOR
Name	:	VICTORIA BOONE
Credential	:	LBA
Telephone Number	:	818-818-3591

Provider Enumeration Date	:	05/08/2019
Last Update Date	:	07/21/2022

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