OLA WELLNESS RETREAT LLC NPI 1336752963

NPI Information

  • NPI: 1336752963
  • Provider Name: OLA WELLNESS RETREAT, LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 05D2188630
  • Address: 26924 PACIFIC COAST HWY
    MALIBU, CA
    ZIP 90265
  • Phone: (888) 595-0235

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NPI Details

OLA WELLNESS RETREAT, LLC is a rehabilitation and substance use disorder clinic center in Malibu, CA. OLA WELLNESS RETREAT, LLC NPI is 1336752963. The provider is registered as an organization entity type.

The provider's business location address is:

26924 PACIFIC COAST HWY
MALIBU, CA
ZIP 90265-356
Phone: (888) 595-0235

The provider's authorized official is Evan Haines .
The authorized official title is Ceo and has the following contact phone number (310) 975-5344.

The CLIA number assigned to this NPI record is 05D2188630 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2020 and was last updated on 8/24/2020.

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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

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This page was last updated on: 11/21/2025

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