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BRENTWOOD - EATING DISORDER CENTER OF CALIFORNIA LLC NPI 1730537754


NPI Information

NPI: 1730537754
Provider Name: BRENTWOOD - EATING DISORDER CENTER OF CALIFORNIA, LLC

Doing Business As: EATING DISORDER CENTER OF CALIFORNIA

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 05D2159904

Address:
520 S SEPULVEDA BLVD STE 208
LOS ANGELES, CA
ZIP 90049
Phone: (310) 472-3728
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BRENTWOOD - EATING DISORDER CENTER OF CALIFORNIA, LLC is a mental health (including community mental health center) clinic center in Los Angeles, CA. BRENTWOOD - EATING DISORDER CENTER OF CALIFORNIA, LLC NPI is 1730537754. The provider is registered as an organization entity type.
The provider Is Doing Business As Eating Disorder Center Of California.

The provider's business location address is:

520 S SEPULVEDA BLVD STE 208
LOS ANGELES, CA
ZIP 90049-536
Phone: (310) 472-3728

The provider's authorized official is Mike Bagley .
The authorized official title is Chief Financial Officer and has the following contact phone number (305) 663-1876.

The CLIA number assigned to this NPI record is 05D2159904 - other - partial mental hlth facil with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2016 and was last updated on 7/27/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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