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NPI Code Detail

MEDICARE: LIONROCK BEHAVIORAL HEALTH, INC

MEDICARE: LIONROCK BEHAVIORAL HEALTH, INC
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1114643988
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIONROCK BEHAVIORAL HEALTH, INC
Provider Business Mailing Address
First Line : 911 LAKEVILLE ST # 322
Second Line :
City : PETALUMA
State : CA
Zip : 94952-3329
Country : US
Telephone Number : 760-994-4990
Fax Number : 866-899-8670
Provider Business Practice Location Address
First Line : 2029 CENTURY PARK E STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90067-2905
Country : US
Telephone Number : 760-994-4990
Fax Number : 866-899-8670
Authorized Official
Title or Position : CFO/SECRETARY/ADMINISTRATOR
Name : IAIN CRABB
Credential :
Telephone Number : 760-994-4990
Provider Enumeration Date : 10/13/2022
Last Update Date : 10/13/2022

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Directions to “LIONROCK BEHAVIORAL HEALTH, INC ” Practice Location

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