Organization · NPI-2
3855 Brunston LLC
Psychiatric Residential Treatment Facility · Hidden Hills, CA
NPI number1376159566
StatusActive
Last updated in NPPESJan 7, 2025
Details
- NPI
- 1376159566
- Entity type
- Organization (NPI-2)
- Legal business name
- 3855 Brunston LLC
- Organization subpart
- No
- Enumeration date
- Sep 22, 2020
- Certification date
- Jan 7, 2025
- Last updated
- Jan 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 323P00000X | Psychiatric Residential Treatment Facility | – | – | Yes |
Practice location
5182 Garrett CtHidden Hills, CA 91302-1143
Phone 888-643-7135
Mailing address
28632 Roadside Dr Ste 235Agoura Hills, CA 91301-6095
Phone 888-643-7135
Authorized official
Krista Dennis
Insurance Manager
8055793537
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