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General NPI Number Information
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NPI Number | 1629933924
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC BEHAVIORAL WELLNESS
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 3556 DARTMOUTH LN
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City | ROWLAND HGHTS
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State | CA
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Zip | 91748-5136
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Country | US
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Telephone | 562-304-5150
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Fax | 565-623-1710
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Provider Business Mailing Address
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Address Line | 3556 DARTMOUTH LN
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City | ROWLAND HGHTS
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State | CA
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Zip | 91748-5136
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Country | US
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Telephone | 562-304-5150
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Fax | 565-623-1710
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Authorized Official
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Title or Position | ENROLLMENT MANAGER
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Name | MR. REVMAX TECHNOLOGIES
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Credential |
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Telephone | 720-784-9413
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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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