Provider Demographics
NPI:1699653030
Name:NACK BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:NACK BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-940-3616
Mailing Address - Street 1:2601 S FIGUEROA ST
Mailing Address - Street 2:BLDG 1, FLR 2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007
Mailing Address - Country:US
Mailing Address - Phone:323-940-3616
Mailing Address - Fax:424-276-0511
Practice Address - Street 1:1001 GAYLEY AVE STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3432
Practice Address - Country:US
Practice Address - Phone:323-940-3616
Practice Address - Fax:424-276-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health