Healthcare Provider Details

I. General information

NPI: 1467222505
Provider Name (Legal Business Name): TCSRZS HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6766 PORTSHEAD RD
MALIBU CA
90265-4262
US

IV. Provider business mailing address

6312 S FIDDLERS GREEN CIR STE 300E
GREENWOOD VILLAGE CO
80111-4831
US

V. Phone/Fax

Practice location:
  • Phone: 805-912-6363
  • Fax:
Mailing address:
  • Phone: 805-912-6363
  • Fax:

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 Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LOUIS CALECA
Title or Position: COO
Credential:
Phone: 303-960-8842