Healthcare Provider Details

I. General information

NPI: 1598410524
Provider Name (Legal Business Name): MERAKI MANAGEMENT - CA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 EL SEGUNDO DR
THOUSAND OAKS CA
91362-2202
US

IV. Provider business mailing address

PO BOX 45973
SAN FRANCISCO CA
94145-0973
US

V. Phone/Fax

Practice location:
  • Phone: 669-777-6709
  • Fax: 669-777-6709
Mailing address:
  • Phone: 314-740-0786
  • Fax: 818-963-5270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHELSEY SORENSEN
Title or Position: VP RCM AND UR
Credential:
Phone: 314-740-0786