PROMINENCE CORPORATION NPI 1790138402

NPI Information

NPI: 1790138402
Provider Name: PROMINENCE CORPORATION

Doing Business As: MALIBU CANYON REHABILITATION

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
4505 LAS VIRGENES RD
SUITE 207
CALABASAS, CA
ZIP 91302
Phone: (818) 878-6900
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PROMINENCE CORPORATION is a rehabilitation and substance use disorder clinic center in Calabasas, CA. PROMINENCE CORPORATION NPI is 1790138402. The provider is registered as an organization entity type.
The provider Is Doing Business As Malibu Canyon Rehabilitation.

The provider's business location address is:

4505 LAS VIRGENES RD
SUITE 207
CALABASAS, CA
ZIP 91302-956
Phone: (818) 878-6900
Fax: (818) 878-6902

The provider's authorized official is Yahya Navab .
The authorized official title is Ceo and has the following contact phone number (310) 433-9656.

The enumeration date for this NPI number is 7/18/2016 and was last updated on 7/18/2016.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	190722BP	CALIFORNIA	Yes

What is NPI?

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This page was last updated on: 4/28/2024

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