MEDICARE: MR. RICHARD GRAY HILL CADC-1

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CI47790625	CA

General Provider Information

NPI Number	:	1851260285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD GRAY HILL CADC-1

Provider Business Mailing Address
First Line	:	24575 TOWN CENTER DR APT 2106
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-1377
Country	:	US
Telephone Number	:	805-506-9619
Fax Number	:	805-506-9619

Provider Business Practice Location Address
First Line	:	2428 N LINCOLN ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2627
Country	:	US
Telephone Number	:	818-824-5238
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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