Healthcare Provider Details

I. General information

NPI: 1902619323
Provider Name (Legal Business Name): ADVOCATE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 W ADAMS BLVD
LOS ANGELES CA
90016-3022
US

IV. Provider business mailing address

9381 E STOCKTON BLVD STE 214
ELK GROVE CA
95624-5070
US

V. Phone/Fax

Practice location:
  • Phone: 916-879-8921
  • Fax:
Mailing address:
  • Phone: 916-879-8921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDRE TRAYNHAM
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 916-879-8921