Healthcare Provider Details

I. General information

NPI: 1184334344
Provider Name (Legal Business Name): BARTON HALL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 CAL CENTER DR STE AND 165
SACRAMENTO CA
95826-3259
US

IV. Provider business mailing address

8950 CAL CENTER DR STE 160
SACRAMENTO CA
95826-3225
US

V. Phone/Fax

Practice location:
  • Phone: 657-304-0103
  • Fax:
Mailing address:
  • Phone: 657-304-0103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GILBERT YATES
Title or Position: CONTRACT MANAGER
Credential:
Phone: 877-262-7803