MONTE NIDO LAKE VISTA LLC NPI 1730357930

NPI Information

NPI: 1730357930
Provider Name: MONTE NIDO LAKE VISTA, LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization

CLIA Number: 05D2092574

Address:
28855 LAKE VISTA DR
AGOURA HILLS, CA
ZIP 91301
Phone: (818) 338-7890
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MONTE NIDO LAKE VISTA, LLC is a community based residential treatment facility mental illness in Agoura Hills, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. MONTE NIDO LAKE VISTA, LLC NPI is 1730357930. The provider is registered as an organization entity type.

The provider's business location address is:

28855 LAKE VISTA DR
AGOURA HILLS, CA
ZIP 91301-801
Phone: (818) 338-7890
Fax: (818) 338-7897

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 05D2092574 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/11/2008 and was last updated on 5/27/2020.

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
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		550000662	CALIFORNIA	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: 11/14/2023

NPI Synchronization or Removal

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