Healthcare Provider Details

I. General information

NPI: 1932484375
Provider Name (Legal Business Name): CAUSE BEHAVIORAL HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

4880 MARKET ST
VENTURA CA
93003-7783
US

V. Phone/Fax

Practice location:
  • Phone: 805-644-7827
  • Fax: 877-644-7545
Mailing address:
  • Phone: 805-644-7827
  • Fax: 877-644-7545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberPSY16222
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberPSY16222
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPSY16222
License Number StateCA

VIII. Authorized Official

Name: DR. DOUG MOES
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D., BCBA-D
Phone: 805-915-9912