MEDICARE: RED ROCK BEHAVIORAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	323P00000X	Psychiatric Residential Treatment Facility
2	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1073473328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED ROCK BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	2915 RED HILL AVE STE A210C
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-7979
Country	:	US
Telephone Number	:	949-506-6162
Fax Number	:

Provider Business Practice Location Address
First Line	:	6419 ELDORA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5260
Country	:	US
Telephone Number	:	949-506-6162
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	EMILY HINSON
Credential	:
Telephone Number	:	949-506-6162

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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