Healthcare Provider Details

I. General information

NPI: 1437597523
Provider Name (Legal Business Name): ALTERNATIVES BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 S ROBERTSON BLVD STE 300
LOS ANGELES CA
90035-1640
US

IV. Provider business mailing address

822 S ROBERTSON BLVD STE 300308
LOS ANGELES CA
90035-1613
US

V. Phone/Fax

Practice location:
  • Phone: 888-532-9137
  • Fax: 888-739-6925
Mailing address:
  • Phone: 888-532-9137
  • Fax: 888-739-6925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSY8246
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number190829AP
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number190829AP
License Number StateCA

VIII. Authorized Official

Name: DR. MARC F. KERN
Title or Position: CLINICAL DIRECTOR, ORGANIZER
Credential: PHD
Phone: 888-532-9137