Healthcare Provider Details

I. General information

NPI: 1760090518
Provider Name (Legal Business Name): HOTEL CALIFORNIA BY THE SEA BELLEVUE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 130TH AVE NE
KIRKLAND WA
98033-8251
US

IV. Provider business mailing address

3419 VIA LIDO STE 145
NEWPORT BEACH CA
92663-3908
US

V. Phone/Fax

Practice location:
  • Phone: 844-766-8717
  • Fax:
Mailing address:
  • Phone: 844-766-8717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BRYAN BIXLER
Title or Position: CHIEF PROGRAM OFFICER
Credential:
Phone: 844-766-8717