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General NPI Number Information
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NPI Number | 1093466047
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Entity Type | Organization
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Legal Business Name | EMBRACE YOUR HEALING BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 15720 VENTURA BLVD STE 609
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City | ENCINO
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State | CA
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Zip | 91436-4733
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Country | US
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Telephone | 833-736-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 15720 VENTURA BLVD STE 609
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City | ENCINO
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State | CA
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Zip | 91436-4733
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SUD/CREDENTIALING MANAGER
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Name | BRANDI DAWN TILMON
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Credential | RADT, MA
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Telephone | 661-246-5122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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