Provider Demographics
NPI:1902295223
Name:MALIBU HILLS TREATMENT CORP
Entity Type:Organization
Organization Name:MALIBU HILLS TREATMENT CORP
Other - Org Name:MALIBU HILLS TREATMENT CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-433-9656
Mailing Address - Street 1:265 WESTLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265
Mailing Address - Country:US
Mailing Address - Phone:818-704-9000
Mailing Address - Fax:
Practice Address - Street 1:265 WESTLAKE BLVD
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265
Practice Address - Country:US
Practice Address - Phone:818-704-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93121324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility