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NPI Code Detail

MEDICARE: GRANDVIEW FOUNDATION, INC.

MEDICARE: GRANDVIEW FOUNDATION, 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
1324500000XSubstance Abuse Rehabilitation Facility190022ANCA

General Provider Information

NPI Number : 1295038404
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANDVIEW FOUNDATION, INC.
Provider Business Mailing Address
First Line : 1230 N MARENGO AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-2217
Country : US
Telephone Number : 626-797-1124
Fax Number : 626-398-9674
Provider Business Practice Location Address
First Line : 1230 N MARENGO AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-2217
Country : US
Telephone Number : 626-797-1124
Fax Number : 626-398-9674
Authorized Official
Title or Position : CEO&EXECUTIVE DIRECT
Name : MR. DOUGLAS LEWIS CAMPBELL
Credential : M.A.
Telephone Number : 626-797-1124
Provider Enumeration Date : 12/09/2010
Last Update Date : 08/13/2013

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Directions to “GRANDVIEW FOUNDATION, INC. ” Practice Location

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