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General NPI Number Information
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NPI Number | 1841914033
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Entity Type | Organization
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Legal Business Name | HILLSIDE HORIZON FOR TEENS, LLC
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 21811 RICHARD ST
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City | PERRIS
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State | CA
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Zip | 92570-8691
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Country | US
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Telephone | 855-746-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 24195 JUANITA DR
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City | CANYON LAKE
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State | CA
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Zip | 92587-9294
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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 | DIRECTOR
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Name | NICHOLAS BEETS
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Credential |
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Telephone | 949-933-1931
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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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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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