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General NPI Number Information
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NPI Number | 1023797222
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS HOME INC.
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 450 S LA PEER DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3504
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Country | US
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Telephone | 310-709-7355
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Fax |
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Provider Business Mailing Address
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Address Line | 450 S LA PEER DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3504
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Country | US
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Telephone | 310-709-7355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAHROUS GHODSIAN
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Credential | MD
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Telephone | 310-709-7355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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