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General NPI Number Information
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NPI Number | 1568322014
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Entity Type | Organization
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Legal Business Name | THE MEADOWGLADE, LLC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 6446 MEADOWGLADE DR
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City | MOORPARK
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State | CA
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Zip | 93021-9705
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Country | US
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Telephone | 888-272-2062
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Fax | 310-919-0372
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Provider Business Mailing Address
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Address Line | 6446 MEADOWGLADE DR
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City | MOORPARK
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State | CA
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Zip | 93021-9705
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Country | US
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Telephone | 888-272-2062
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Fax | 310-919-0372
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | TERRY SCHOSER
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Credential |
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Telephone | 323-364-6489
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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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