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General NPI Number Information
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NPI Number | 1902252398
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Entity Type | Organization
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Legal Business Name | LIONROCK BEHAVIORAL HEALTH, INC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 220 S MAIN ST # 37
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City | ROYAL OAK
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State | MI
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Zip | 48067-2612
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Country | US
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Telephone | 760-994-4990
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Fax | 866-899-8670
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Provider Business Mailing Address
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Address Line | 911 LAKEVILLE ST # 322
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City | PETALUMA
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State | CA
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Zip | 94952-3329
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Country | US
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Telephone | 760-994-4990
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Fax | 866-899-8670
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Authorized Official
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Title or Position | CFO/SECRETARY/ADMINISTRATOR
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Name | IAIN CRABB
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Credential |
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Telephone | 760-994-4990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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