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General NPI Number Information
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NPI Number | 1154773877
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Entity Type | Organization
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Legal Business Name | HILLSIDE MALIBU CORP
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 4505 LAS VIRGENES RD SUITE 211
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City | CALABASAS
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State | CA
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Zip | 91302-1956
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Country | US
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Telephone | 818-706-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 4505 LAS VIRGENES RD SUITE 211
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City | CALABASAS
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State | CA
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Zip | 91302-1956
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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 | CEO
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Name | MR. YAHYA NAVAB
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Credential |
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Telephone | 818-706-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 190971AP
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 190971AP
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License Number State | CA
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