Healthcare Provider Details

I. General information

NPI: 1003661737
Provider Name (Legal Business Name): TML BEHAVIORAL HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27823 VILLA CANYON RD
CASTAIC CA
91384-3731
US

IV. Provider business mailing address

21125 CENTRE POINTE PKWY
SANTA CLARITA CA
91350-2994
US

V. Phone/Fax

Practice location:
  • Phone: 855-435-3801
  • Fax:
Mailing address:
  • Phone: 855-435-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KASEY BOGOJE
Title or Position: OWNER
Credential: LMFT
Phone: 855-435-3801