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General NPI Number Information
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NPI Number | 1649012568
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Entity Type | Organization
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Legal Business Name | REDEMPTIO LLC
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Dates
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Enumeration Date | 06/11/2024
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 145 ERTEN ST
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1810
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Country | US
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Telephone | 805-870-4345
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Fax |
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Provider Business Mailing Address
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Address Line | 2060-D AVENIDA DE LOS ARBOLES #608
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City | THOUSAND OAKS
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State | CA
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Zip | 91362
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Country | US
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Telephone | 310-428-2431
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | SHANNON DOBBS
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Credential | PSY
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Telephone | 310-428-2431
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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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