Provider Demographics
NPI:1538538574
Name:ACADIA MALIBU, INC.
Entity type:Organization
Organization Name:ACADIA MALIBU, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-579-5192
Mailing Address - Street 1:30765 PACIFIC COAST HIGHWAY, #135
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-3643
Mailing Address - Country:US
Mailing Address - Phone:805-370-8048
Mailing Address - Fax:310-919-3684
Practice Address - Street 1:3743, 3743 1/2, AND 3744 SOUTH BARRINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066
Practice Address - Country:US
Practice Address - Phone:805-320-8048
Practice Address - Fax:310-919-3684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190786AP324500000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility