Monte Nido Lake Vista, Llc, NPI 1780105551
Adolescent and Children Mental Health Clinic/Center in Agoura Hills, CA, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1780105551
NPI Entity Type Organization
Provider Name Monte Nido Lake Vista, Llc
Doing Business As
Subpart of Organization Monte Nido Lake Vista, Llc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 29470 Lake Vista Dr, Agoura Hills, CA, US
Provider Mailing Address 6100 Sw 76th St, South Miami, FL, US, 331435002
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name MR. Mike Bagley
Official Position CHIEF FINANCIAL OFFICER
Phone 305-663-1876

Primary Taxonomy

Taxonomy Code

261QM0855X

Taxonomy Name Adolescent and Children Mental Health Clinic/Center
Classification

Clinic/Center

Group

Ambulatory Health Care Facilities

Description 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.

Other Organization Name

Clementine Malibu Lake
Doing Business As

Business Address

Monte Nido Lake Vista, Llc
29470 Lake Vista Dr

Agoura Hills, CA, US

Phone: 747-212-5021
Fax: 818-575-7327

Mailing Address

Monte Nido Lake Vista, Llc
6100 Sw 76th St
South Miami, FL, US
ZIP 331435002
Phone: 305-663-1876
Fax: 786-359-4485

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