PACIFIC TEEN TREATMENT LLC (NPI# 1336614296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336614296 |
| Entity Type | Organization |
| Organization Name | PACIFIC TEEN TREATMENT LLC |
| Practice Address |
29053 Pacific Coast Hwy Malibu CA 90265-3948 |
| Practice Telephone | 9176627192 |
| Mailing Telephone | 9176627192 |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |
| Authorized Official Name | JEREMY MANNE (CEO) |
| Authorized Official Telephone | 9176627192 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
29053 PACIFIC COAST HWY |
| City | MALIBU |
| State | CA |
| Zip Code | 90265-3948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884909 | Montage Recovery Ca LLC | Psychiatric Residential Treatment Facility | 2890 Kana Dume, Malibu, CA 90265 | 2020-09-03 |
| 1912518887 | Oconnor Optometric Inc | Optometrist | 23401 Civic Center Way, Unit 2b, Malibu, CA 90265 | 2020-08-13 |
| 1184234593 | Jessica Gash | Student in an Organized Health Care Education/Training Program | 24420 Tiner Court, Malibu, CA 90265 | 2020-07-31 |
| 1902438393 | Montage Recovery Ca, LLC | Clinic/Center | 2890 Kanan Dume Road, Malibu, CA 90265 | 2020-02-04 |
| 1164909032 | Joseph Turcillo | Internal Medicine | 3065 Malibu Country Dr, Malibu, CA 90265 | 2018-07-24 |
| 1356830657 | Samantha Erin Schlossmann | Clinical Neuropsychologist | 28348 Rey De Copas Lane, Malibu, CA 90265 | 2018-05-02 |
| 1740783653 | Adam Dov Greenberg | Acupuncturist | 5853 Filaree Hts., Malibu, CA 90265 | 2018-03-16 |
| 1225556673 | Jeff Harris, M.d. A Medical Corporation | Pediatrics | 23805 Stuart Ranch Rd. #310, Malibu, CA 90265 | 2017-09-06 |
| 1184177347 | Michael J. Maguire Acupuncturist, Inc. | Acupuncturist | 28990 PCh, Building B Ste 211, Malibu, CA 90265 | 2016-07-25 |
| 1093182198 | Recovery Malibu, Inc. | Substance Abuse Rehabilitation Facility | 20723 Rockcroft Dr., Malibu, CA 90265 | 2015-08-25 |
| Find all providers in zip 90265 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| 1083231781 | Treehouse Child Therapy Professional Corporation | Clinic/Center | 514 N California Ave Ste 13, Beaumont, CA 92223-2120 | 2020-06-29 |
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| 1447876123 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 454 E Cerritos St, Rialto, CA 92376-3658 | 2020-06-18 |
| 1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
| 1386267870 | Bni Treatment Centers | Clinic/Center | 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 | 2020-05-19 |
| 1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.