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Montage Recovery Ca, LLC

Psychiatric Residential Treatment Facility in Malibu, CA. Organization (NPI-2).

NPI number1902438393
StatusActive
Last updated in NPPESSep 1, 2020

Details

NPI
1902438393
Entity type
Organization (NPI-2)
Legal business name
Montage Recovery Ca, LLC
Organization subpart
Yes
Enumeration date
Feb 4, 2020
Certification date
Aug 31, 2020
Last updated
Sep 1, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
323P00000X Psychiatric Residential Treatment Facility––Yes
261QM0850X Clinic/Center, Adult Mental Health––

Other names

  • Renewal Behavioral Health Outpatient (Doing Business As)
  • Costa Colina-Kanan Dume (Doing Business As)

Practice location

2890 Kanan Dume Road
Malibu, CA 90265

Phone 818-299-3602 · Fax 805-830-1565

Mailing address

203 S Orange Dr
Los Angeles, CA 90036-3010

Phone 805-702-4273 · Fax 818-830-1565

Other practice locations

1129 S Gramercy Dr
Los Angeles, CA 90019-3610

Phone 805-702-4273 · Fax 818-698-6442

Authorized official

Joann Zuniga
Director
8056160719

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