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General NPI Number Information
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NPI Number | 1336864610
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Entity Type | Organization
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Legal Business Name | SACRAMENTO REHAB LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 7248 S LAND PARK DR STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95831-3661
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Country | US
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Telephone | 510-283-7842
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Fax |
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Provider Business Mailing Address
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Address Line | 240 S RODEO DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3804
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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 | OWNER
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Name | NATHAN YOUNG
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Credential |
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Telephone | 213-305-9332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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