Healthcare Provider Details

I. General information

NPI: 1124914973
Provider Name (Legal Business Name): MULHOLLAND HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 COCHRAN ST
SIMI VALLEY CA
93063-2528
US

IV. Provider business mailing address

20555 DEVONSHIRE ST # 448
CHATSWORTH CA
91311-3208
US

V. Phone/Fax

Practice location:
  • Phone: 805-410-0056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RYELY OHOP
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 805-410-0056