MONTE NIDO LAKE VISTA, LLC (NPI# 1730357930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730357930 |
| Entity Type | Organization |
| Organization Name | MONTE NIDO LAKE VISTA, LLC |
| Practice Address |
28855 Lake Vista Dr Agoura Hills CA 91301-2801 |
| Mailing Address |
6100 Sw 76th St South Miami FL 33143-5002 |
| Practice Telephone | 8183387890 |
| Practice Fax Number | 8183387897 |
| Mailing Telephone | 3056631876 |
| Mailing Fax Number | 7863594485 |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2020-05-27 |
| Authorized Official Name | MIKE BAGLEY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3056631876 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 550000662 | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053934984 | Monte Nido Lake Vista, LLC | Community Based Residential Treatment Facility, Mental Illness | 1776 Ivanhoe Ave, Lafayette, CA 94549-1954 | 2020-05-27 |
| 1780105551 | Monte Nido Lake Vista, LLC | Clinic/Center | 29470 Lake Vista Dr, Agoura Hills, CA 91301-2818 | 2017-07-03 |
| Street Address |
28855 LAKE VISTA DR |
| City | AGOURA HILLS |
| State | CA |
| Zip Code | 91301-2801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770126823 | Krista Marie Windisch | Technician | 5836 Stonecrest Drive, Agoura, CA 91301 | 2019-10-22 |
| 1154872372 | Evolve Growth Initiatives LLC | Clinic/Center | 6425 Chesebro Road, Agoura, CA 91301 | 2016-10-24 |
| 1760851224 | Robert Kevin Ryan | Counselor | 28310 Roadside Drive Suite 235, Agoura Hills, CA 91301 | 2015-09-15 |
| 1922484054 | Mahyar Okhovat, M.d. Inc | Psychiatry & Neurology | 2925 Canwood St, 109, Agoural Hills, CA 91301 | 2015-07-30 |
| 1982083929 | Alfred Charles Deciutiis Jr. | Internal Medicine | 32062 1/2 Lobo Canyon, Agoura, CA 91301 | 2015-05-22 |
| 1821401787 | Brandie Boghosian | Psychologist | 30200 Agoura Rd Ste 190, Agoura, CA 91301 | 2014-06-09 |
| 1114339041 | Unique Care Los Angeles Hospice, Inc. | Hospice Care, Community Based | 27001 Agoura Rd #110, Calabasas, CA 91301 | 2014-05-27 |
| 1588905574 | Irit Almog | Marriage & Family Therapist | 5308 Derry Ave Ste L201, Agoura Hills, CA 91301 | 2013-03-15 |
| 1902152507 | Bethany Vaudrey | Psychologist | 28328 Agoura Rd Ste 102, Agoura Hills, CA 91301 | 2012-08-01 |
| 1508142472 | Jill Torres | Psychologist | 28729 Roadside Dr Ste 151, Agoura Hills, CA 91301 | 2011-10-24 |
| Find all providers in zip 91301 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
| 1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
| 1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
| City | AGOURA HILLS |
| Zip Code | 91301 |
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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.