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General NPI Number Information
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NPI Number | 1639887326
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Entity Type | Organization
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Legal Business Name | CHANNEL ISLANDS REHAB, LLC
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 4474 MARKET ST STE 505
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City | VENTURA
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State | CA
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Zip | 93003-5812
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Country | US
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Telephone | 805-218-0079
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Fax | 805-834-0288
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Provider Business Mailing Address
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Address Line | 4744 TELEPHONE RD STE 3
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City | VENTURA
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State | CA
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Zip | 93003-5258
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Country | US
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Telephone | 214-934-8999
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Fax | 805-834-0288
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Authorized Official
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Title or Position | CEO
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Name | DR. ALLISON HOPKINS
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Credential | PH.D.
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Telephone | 214-934-8999
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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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