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General NPI Number Information
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NPI Number | 1255797163
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Entity Type | Organization
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Legal Business Name | INSIGHT BEHAVIORAL HEALTH, INC
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 769 N ORANGE GROVE BLVD
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City | PASADENA
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State | CA
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Zip | 91103-3331
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Country | US
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Telephone | 626-564-2703
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Fax | 626-564-2707
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Provider Business Mailing Address
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Address Line | 14156 MAGNOLIA BLVD STE 101
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-1181
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Country | US
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Telephone | 818-501-3512
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Fax | 818-501-7148
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | MR. ANTHONY LOPEZ
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Credential |
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Telephone | 818-501-3512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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