Provider Demographics
NPI:1003536491
Name:BRIGHTVIEW BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:BRIGHTVIEW BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECRUITING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KALLI
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDENHOUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-410-0299
Mailing Address - Street 1:1054 W 45TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 S LAKE AVE STE 300
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-3009
Practice Address - Country:US
Practice Address - Phone:626-410-0299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty