Provider Demographics
NPI:1861051294
Name:GOLDEN HILLMONT HOUSE MHRC, LLC
Entity type:Organization
Organization Name:GOLDEN HILLMONT HOUSE MHRC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-960-0295
Mailing Address - Street 1:13347 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4267
Mailing Address - Country:US
Mailing Address - Phone:818-385-3219
Mailing Address - Fax:
Practice Address - Street 1:1750A S LEWIS RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8520
Practice Address - Country:US
Practice Address - Phone:805-765-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health