Healthcare Provider Details

I. General information

NPI: 1437067543
Provider Name (Legal Business Name): NACK BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 SHATTUCK AVE STE 200
BERKELEY CA
94704-5940
US

IV. Provider business mailing address

2601 S FIGUEROA ST, BLDG 1, FL 2
LOS ANGELES CA
90007-3254
US

V. Phone/Fax

Practice location:
  • Phone: 323-940-3616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLE ADAMS
Title or Position: FOUNDER AND CEO
Credential:
Phone: 323-940-3616