Healthcare Provider Details

I. General information

NPI: 1700441359
Provider Name (Legal Business Name): THE HAMILTON CENTER FOR MENTAL AND BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WIGWAM PKWY STE 100
HENDERSON NV
89074-8164
US

IV. Provider business mailing address

23679 CALABASAS RD STE 954
CALABASAS CA
91302-1502
US

V. Phone/Fax

Practice location:
  • Phone: 833-288-4764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA BOONE
Title or Position: CEO/EXECUTIVE DIRECTOR
Credential: LBA
Phone: 818-818-3591