MEDICARE: RESET 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1578495305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESET BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	2107 COSMO WAY
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92078-0970
Country	:	US
Telephone Number	:	858-395-3696
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 WRIGHT PL
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-6583
Country	:	US
Telephone Number	:	858-395-3696
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DANIEL MARC LEIDERMAN
Credential	:
Telephone Number	:	858-395-3696

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “RESET BEHAVIORAL HEALTH LLC ” Practice Location

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